Construction Loan Application

Complete only if for joint or secured credit, or applicant resides in a community property state or is relying on property located in such a state.

Applicant:

Co-Applicant:

Applicant Information

Name:

Home Phone:

Previous address, city, state and zip:
(if less than 2 years)

Current address, city, state and zip:

Do you own or rent:

Own Rent

Years There:

Current Value (if own):

Social Security Number:

Date of Birth:

Employer:

Years at Employment:

Position:

*Annual Income:

Work Phone:

Previous Employer:
(if with current employer less than 2 years)

Co-Applicant Information

Name:

Home Phone:

Previous address, city, state and zip:
(if less than 2 years)

Current address, city, state and zip:

Social Security Number:

Date of Birth:

Employer:

Years at Employment:

Position:

*Annual Income:

Work Phone:

Previous Employer:
(if with current employer less than 2 years)

* You need not list income from alimony, child support or separate maintenance unless you wish it considered for the purpose of repaying this obligation.
** A married Wisconsin resident applying for credit in his / her own name must complete the required spousal information in the co-applicant section.

Debts And Obligation

1st Mortgage Lender Name:

Address:

Monthly Payment:

Interest Rate:

Unpaid Balance:

2nd Mortgage Lender Name:

Address:

Monthly Payment:

Interest Rate:

Unpaid Balance:

Auto Lender:

Monthly Payment:

Unpaid Balance:

Credit Cards / Personal Loans

Name of Credit Card / Lender:

Minimum Monthly Payment:

Unpaid Balance:

Name of Credit Card / Lender:

Minimum Monthly Payment:

Unpaid Balance:

Name of Credit Card / Lender:

Minimum Monthly Payment:

Unpaid Balance:

Additional Information (i.e. name of banker you are currently working with, etc.):

If the credit line or loan is for home purchase, refinance, construction-to-perm, repair or maintenance , the following information is requested by the Federal government to monitor this lender's compliance with the Equal Credit Opportunity and Fair Housing Laws. The law provides that a lender may neither discriminate on the basis of this information nor on whether or not it is furnished. If you do not wish to furnish this information please indicate below.

The creditor shall also inform the applicant(s) that if the applicant(s) chooses not to provide the information, the creditor is required to note the race or national origin and sex on the basis of visual observation or surname.

If your request is not for the purpose of home purchase, refinance, construction-to-perm, repair or maintenance, do not fill in this section.

Applicant:

I do not wish to furnish this information

Race or National Origin:

Sex:

Ethnicity:

Co-Applicant:

I do not wish to furnish this information

Race or National Origin:

Sex:

Ethnicity:

Authorization To Release Information

I authorize Port Washington State Bank to obtain my / our credit report for the purpose of determining credit worthiness. The information that is obtained is strictly confidential. A photocopy or fax of this authorization may be deemed to be the equivalent of the original.

For Married Applicant Applying For Separate Credit

The credit being applied for, if granted will be incurred in the interest of my marriage or family.

NOTICE TO MARRIED APPLICANTS: No provision of any marital property agreement, unilateral statement under s788.58, Wis Stats, or court decree under s788.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred.

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